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Ma B, Xiu L, Ding L. The m6 RNA methylation regulator KIAA1429 is associated with autophagy-mediated drug resistance in lung cancer. FASEB Bioadv 2024; 6:105-117. [PMID: 38585432 PMCID: PMC10995705 DOI: 10.1096/fba.2023-00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 04/09/2024] Open
Abstract
N6-methyladenosine (m6A) modification plays a crucial role in cancer progression. However, the role of m6A modification-mediated autophagy underlying non-small cell lung cancer (NSCLC) gefitinib resistance remains unknown. Here, we discovered that m6A methyltransferase KIAA1429 was highly expressed in NSCLC gefitinib-resistant cells (PC9-GR) as well as tissues, and KIAA1429 high expression was associated with poor survival. In addition, silent KIAA1429 repressed gefitinib resistance in NSCLC and reduced tumor growth in vivo. Mechanistically, KIAA1429 stabilized WTAP, a significant player in autophagy, by binding to the 3' untranslated regions (3'-UTR) of WTAP. In a word, our findings indicated that KIAA1429 could elevate NSCLC gefitinib resistance, which may provide a promising targeted therapy for NSCLC patients.
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Affiliation(s)
- Bo Ma
- Department of General Thoracic SurgeryGeneral Hospital of Ningxia Medical UniversityYinchuanChina
| | - Lei Xiu
- Department of Thoracic and Cardiac SurgeryGeneral Hospital of Ningxia Medical UniversityYinchuanChina
| | - Lili Ding
- Department of Obstetrics and Gynecology ExaminationGeneral Hospital of Ningxia Medical UniversityYinchuanChina
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2
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Orozco RAP, Padilla-Guzmán A, Forero-Delgadillo JM, Jiménez VAO, Pachajoa H, Parra NJV, Restrepo JM. Schimke immuno-osseous dysplasia. A case report in Colombia. Mol Genet Metab Rep 2023; 37:100995. [PMID: 37662493 PMCID: PMC10472290 DOI: 10.1016/j.ymgmr.2023.100995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 09/05/2023] Open
Abstract
Background Schimke immune-osseous dysplasia (SIOD) is an ultra-rare multisystemic, monogenic, and autosomal recessive inherited disease caused by biallelic mutations in the SMARCAL1 gene. Approximately 100 cases have been reported worldwide. The disease is characterized by skeletal, renal, and immunological abnormalities. Case description This is a 6-year-old female patient who debuted with nephrotic syndrome at five years of age, with a switch to corticosteroid resistance and poor response to immunosuppressive treatment received. The patient was admitted and referred to our institution due to convulsive status. During her hospitalization, thrombosis was found in the left renal vein, and a renal biopsy report of Collapsing Focal and Segmental Glomerulosclerosis (FSGS) was obtained. The patient had multiple infections during hospitalization, with T lymphocyte lymphopenia and severe IgG hypogammaglobulinemia. Additionally, given dysmorphic facies, delayed weight-height development, and spondyloepiphyseal dysplasia, exome sequencing was performed, finding an homozygous pathogenic variant c.1933C > T p.Arg645Cys in SMARCAL1, compatible with the diagnosis of SIOD. Discussion We present the case of a patient that exhibited a severe phenotype of the disease, with skeletal, renal, severe combined immunological compromise and cerebrovascular involvement during follow-up, and the available proposed mechanisms of the disease focused on the clinical manifestations of this patient. It is the first case of SIOD reported in Colombia and the first comprehensive characterization reported in the literature of a patient with homozygosity of the known variant c.1933C > T p.Arg645Cys. Conclusion A severe phenotype of the disease with cerebrovascular involvement by homozygosity of the known variant c.1933C > T p.Arg645Cys in the SMARCAL1 gene can be expected.
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Affiliation(s)
| | | | - Jessica María Forero-Delgadillo
- Servicio de nefrología pediátrica, Departamento de salud maternoinfantil, Fundación Valle del Lili, Cali, Colombia
- Facultad de ciencias de la salud, Universidad Icesi, Cali, Colombia
| | - Vanessa Amparo Ochoa Jiménez
- Servicio de nefrología pediátrica, Departamento de salud maternoinfantil, Fundación Valle del Lili, Cali, Colombia
- Facultad de ciencias de la salud, Universidad Icesi, Cali, Colombia
| | - Harry Pachajoa
- Servicio de genética, Fundación Valle del Lili, Cali, Colombia
- Facultad de ciencias de la salud, Universidad Icesi, Cali, Colombia
- Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
| | | | - Jaime M. Restrepo
- Servicio de nefrología pediátrica, Departamento de salud maternoinfantil, Fundación Valle del Lili, Cali, Colombia
- Facultad de ciencias de la salud, Universidad Icesi, Cali, Colombia
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3
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Sobrino S, Abdo C, Neven B, Denis A, Gouge-Biebuyck N, Clave E, Charbonnier S, Blein T, Kergaravat C, Alcantara M, Villarese P, Berthaud R, Dehoux L, Albinni S, Karkeni E, Lagresle-Peyrou C, Cavazzana M, Salomon R, André I, Toubert A, Asnafi V, Picard C, Blanche S, Macintyre E, Boyer O, Six E, Zuber J. Human kidney-derived hematopoietic stem cells can support long-term multilineage hematopoiesis. Kidney Int 2023; 103:70-76. [PMID: 36108807 DOI: 10.1016/j.kint.2022.08.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/23/2022] [Accepted: 08/12/2022] [Indexed: 01/10/2023]
Abstract
Long-term multilineage hematopoietic donor chimerism occurs sporadically in patients who receive a transplanted solid organ enriched in lymphoid tissues such as the intestine or liver. There is currently no evidence for the presence of kidney-resident hematopoietic stem cells in any mammal species. Graft-versus-host-reactive donor T cells promote engraftment of graft-derived hematopoietic stem cells by making space in the bone marrow. Here, we report full (over 99%) multilineage, donor-derived hematopoietic chimerism in a pediatric kidney transplant recipient with syndromic combined immune deficiency that leads to transplant tolerance. Interestingly, we found that the human kidney-derived hematopoietic stem cells took up long-term residence in the recipient's bone marrow and gradually replaced their host counterparts, leading to blood type conversion and full donor chimerism of both lymphoid and myeloid lineages. Thus, our findings highlight the existence of human kidney-derived hematopoietic stem cells with a self-renewal ability able to support multilineage hematopoiesis.
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Affiliation(s)
- Steicy Sobrino
- INSERM UMR_S1163, Institut IMAGINE, Paris, France; Université Paris Cité, Paris, France
| | - Chrystelle Abdo
- Université Paris Cité, Paris, France; Laboratoire d'Onco-Hématologie, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Bénédicte Neven
- Université Paris Cité, Paris, France; Service d'Immuno-Hématologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | | | - Nathalie Gouge-Biebuyck
- Service de Néphrologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Emmanuel Clave
- INSERM UMR_S1160, Institut de Recherche Saint Louis, Paris, France
| | | | | | | | - Marion Alcantara
- Université Paris Cité, Paris, France; Laboratoire d'Onco-Hématologie, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Patrick Villarese
- Laboratoire d'Onco-Hématologie, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Romain Berthaud
- Université Paris Cité, Paris, France; Service de Néphrologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Laurène Dehoux
- Service de Néphrologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Souha Albinni
- Etablissement Français du Sang Ile-de-France, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Esma Karkeni
- Cytometry and Biomarkers UTechS, Center for Translational Science, Institut Pasteur, Paris, France
| | | | - Marina Cavazzana
- INSERM UMR_S1163, Institut IMAGINE, Paris, France; Université Paris Cité, Paris, France
| | - Rémi Salomon
- Université Paris Cité, Paris, France; Service de Néphrologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | | | - Antoine Toubert
- Université Paris Cité, Paris, France; INSERM UMR_S1160, Institut de Recherche Saint Louis, Paris, France
| | - Vahid Asnafi
- Université Paris Cité, Paris, France; Laboratoire d'Onco-Hématologie, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Capucine Picard
- INSERM UMR_S1163, Institut IMAGINE, Paris, France; Université Paris Cité, Paris, France; CEDI, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Stéphane Blanche
- Université Paris Cité, Paris, France; Service d'Immuno-Hématologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Elizabeth Macintyre
- Université Paris Cité, Paris, France; Laboratoire d'Onco-Hématologie, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Olivia Boyer
- Université Paris Cité, Paris, France; Service de Néphrologie Pédiatrique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France
| | | | - Julien Zuber
- INSERM UMR_S1163, Institut IMAGINE, Paris, France; Université Paris Cité, Paris, France; Service des Maladies du Rein et Métabolisme, Transplantation et Immunologie Clinique, Hôpital Necker, Assistance-Publique Hôpitaux de Paris, Paris, France.
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Marin AV, Jiménez-Reinoso A, Mazariegos MS, Román-Ortiz E, Regueiro JR. T-cell receptor signaling in Schimke immuno-osseous dysplasia is SMARCAL1-independent. Front Immunol 2022; 13:979722. [PMID: 36330520 PMCID: PMC9623027 DOI: 10.3389/fimmu.2022.979722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/22/2022] [Indexed: 11/26/2022] Open
Abstract
Schimke immuno-osseous dysplasia (SIOD) caused by mutations in SMARCAL1 is an ultra-rare disease characterized by specific facial features, skeletal dysplasia, and steroid-resistant nephrotic syndrome, which often leads to kidney failure and requires transplantation. Cellular (T-cell) deficiency, lymphopenia, and infections have been frequently reported, but whether they are due to T-cell-intrinsic defects in T-cell receptor (TCR) signaling associated with SMARCAL1 deficiency or to T-cell-extrinsic effects such as the impaired proliferation of hematopoietic precursors or T-cell-specific immunosuppression after renal transplantation remains unknown. We have explored the effects of SMARCAL1 deficiency on T-cell receptor signaling in primary and immortalized T cells from a 9-year-old SIOD patient under immunosuppression treatment when compared to healthy donors. Immortalized T cells recapitulated the SMARCAL1 deficiency of the patient, as judged by their impaired response to gamma irradiation. The results indicated that TCR-mediated signaling was normal in SIOD-derived immortalized T cells but strongly impaired in the primary T cells of the patient, although rescued with TCR-independent stimuli such as PMA + ionomycin, suggesting that SIOD-associated T-cell signaling is not intrinsically defective but rather the result of the impaired proliferation of hematopoietic precursors or of T-cell-specific immunosuppression. The lack of early thymic emigrants in our patients may support the former hypothesis.
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Affiliation(s)
- Ana V. Marin
- Department of Immunology, Ophthalmology and Ear, Nose and Throat (ENT), Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Anaïs Jiménez-Reinoso
- Department of Immunology, Ophthalmology and Ear, Nose and Throat (ENT), Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Marina S. Mazariegos
- Department of Immunology, Ophthalmology and Ear, Nose and Throat (ENT), Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Elena Román-Ortiz
- Pediatric Nephrology, Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - José R. Regueiro
- Department of Immunology, Ophthalmology and Ear, Nose and Throat (ENT), Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
- *Correspondence: José R. Regueiro,
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Rossini L, Durante C, Bresolin S, Opocher E, Marzollo A, Biffi A. Diagnostic Strategies and Algorithms for Investigating Cancer Predisposition Syndromes in Children Presenting with Malignancy. Cancers (Basel) 2022; 14:cancers14153741. [PMID: 35954404 PMCID: PMC9367486 DOI: 10.3390/cancers14153741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Here we provide an overview of several genetically determined conditions that predispose to the development of solid and hematologic malignancies in children. Diagnosing these conditions, whose prevalence is estimated around 10% in children with cancer, is useful to warrant personalized oncologic treatment and follow-up, as well as psychological and genetic counseling to these children and their families. We reviewed the most recent studies focusing on the prevalence of cancer predisposition syndromes in cancer-bearing children and the most-used clinical screening tools. Our work highlighted the value of clinical screening tools in the management of young cancer patients, especially in settings where genetic testing is not promptly accessible. Abstract In the past recent years, the expanding use of next-generation sequencing has led to the discovery of new cancer predisposition syndromes (CPSs), which are now known to be responsible for up to 10% of childhood cancers. As knowledge in the field is in constant evolution, except for a few “classic” CPSs, there is no consensus about when and how to perform germline genetic diagnostic studies in cancer-bearing children. Several clinical screening tools have been proposed to help identify the patients who carry higher risk, with heterogeneous strategies and results. After introducing the main clinical and molecular features of several CPSs predisposing to solid and hematological malignancies, we compare the available clinical evidence on CPS prevalence in pediatric cancer patients and on the most used decision-support tools in identifying the patients who could benefit from genetic counseling and/or direct genetic testing. This analysis highlighted that a personalized stepwise approach employing clinical screening tools followed by sequencing in high-risk patients might be a reasonable and cost-effective strategy in the care of children with cancer.
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Affiliation(s)
- Linda Rossini
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
| | - Caterina Durante
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
| | - Silvia Bresolin
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
- Maternal and Child Health Department, Padua University, Via Giustiniani, 3, 35128 Padua, Italy
| | - Enrico Opocher
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
| | - Antonio Marzollo
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
- Correspondence: (A.M.); (A.B.)
| | - Alessandra Biffi
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128 Padua, Italy; (L.R.); (C.D.); (S.B.); (E.O.)
- Maternal and Child Health Department, Padua University, Via Giustiniani, 3, 35128 Padua, Italy
- Correspondence: (A.M.); (A.B.)
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Conti F, Marzollo A, Moratti M, Lodi L, Ricci S. Inborn Errors of Immunity underlying a susceptibility to pyogenic infections: from innate immune system deficiency to complex phenotypes. Clin Microbiol Infect 2022; 28:1422-1428. [DOI: 10.1016/j.cmi.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/29/2022] [Accepted: 05/14/2022] [Indexed: 12/26/2022]
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7
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Romano R, Cillo F, Moracas C, Pignata L, Nannola C, Toriello E, De Rosa A, Cirillo E, Coppola E, Giardino G, Brunetti-Pierri N, Riccio A, Pignata C. Epigenetic Alterations in Inborn Errors of Immunity. J Clin Med 2022; 11:jcm11051261. [PMID: 35268351 PMCID: PMC8910960 DOI: 10.3390/jcm11051261] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 02/07/2023] Open
Abstract
The epigenome bridges environmental factors and the genome, fine-tuning the process of gene transcription. Physiological programs, including the development, maturation and maintenance of cellular identity and function, are modulated by intricate epigenetic changes that encompass DNA methylation, chromatin remodeling, histone modifications and RNA processing. The collection of genome-wide DNA methylation data has recently shed new light into the potential contribution of epigenetics in pathophysiology, particularly in the field of immune system and host defense. The study of patients carrying mutations in genes encoding for molecules involved in the epigenetic machinery has allowed the identification and better characterization of environment-genome interactions via epigenetics as well as paving the way for the development of new potential therapeutic options. In this review, we summarize current knowledge of the role of epigenetic modifications in the immune system and outline their potential involvement in the pathogenesis of inborn errors of immunity.
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Affiliation(s)
- Roberta Romano
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Francesca Cillo
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Cristina Moracas
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Laura Pignata
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Chiara Nannola
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Elisabetta Toriello
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Antonio De Rosa
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Emilia Cirillo
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Emma Coppola
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Giuliana Giardino
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Nicola Brunetti-Pierri
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
| | - Andrea Riccio
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
- Correspondence: (A.R.); (C.P.)
| | - Claudio Pignata
- Department of Translational Medical Sciences, Università degli Studi di Napoli “Federico II”, 80125 Naples, Italy; (R.R.); (F.C.); (C.M.); (C.N.); (E.T.); (A.D.R.); (E.C.); (E.C.); (G.G.); (N.B.-P.)
- Correspondence: (A.R.); (C.P.)
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Carneiro-Sampaio M, de Jesus AA, Bando SY, Moreira-Filho CA. Inborn Errors of Immunity With Fetal or Perinatal Clinical Manifestations. Front Pediatr 2022; 10:891343. [PMID: 35601409 PMCID: PMC9121170 DOI: 10.3389/fped.2022.891343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/18/2022] [Indexed: 11/28/2022] Open
Abstract
In this article we revised the literature on Inborn Errors of Immunity (IEI) keeping our focus on those diseases presenting with intrauterine or perinatal clinical manifestations. We opted to describe our findings according to the IEI categories established by the International Union of Immunological Societies, predominantly addressing the immunological features of each condition or group of diseases. The main finding is that such precocious manifestations are largely concentrated in the group of primary immune regulatory disorders (PIRDs) and not in the group of classical immunodeficiencies. The IEI categories with higher number of immunological manifestations in utero or in perinatal period are: (i) diseases of immune dysregulation (HLH, IPEX and other Tregopathies, autosomal recessive ALPS with complete lack of FAS protein expression) and (ii) autoinflammatory diseases (NOMID/CINCA, DIRA and some interferonopathies, such as Aicardi-Goutières syndrome, AGS, and USP18 deficiency). Regarding the other IEI categories, some patients with Omenn syndrome (an atypical form of SCID), and a few X-linked CGD patients present with clinical manifestations at birth associated to immune dysregulation. The most frequent clinical features were hydrops fetalis, intrauterine growth retardation leading to fetal loss, stillbirths, and prematurity, as in HLH and IPEX. Additionally, pseudo-TORCH syndrome was observed in AGS and in USP18 deficiency. The main goal of our review was to contribute to increasing the medical awareness of IEI with intrauterine and perinatal onset, which has obvious implications for diagnosis, treatment, and genetic counseling.
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Affiliation(s)
- Magda Carneiro-Sampaio
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, Sao-Paulo, Brazil
| | - Adriana Almeida de Jesus
- Translational Autoinflammatory Disease Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Silvia Yumi Bando
- Department of Pediatrics, Faculdade de Medicina, Universidade de São Paulo, Sao-Paulo, Brazil
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Marzollo A, Conti F, Rossini L, Rivalta B, Leonardi L, Tretti C, Tosato F, Chiriaco M, Ursu GM, Natalucci CT, Martella M, Borghesi A, Mancini C, Ciolfi A, di Matteo G, Tartaglia M, Cancrini C, Dotta A, Biffi A, Finocchi A, Bresolin S. Neonatal Manifestations of Chronic Granulomatous Disease: MAS/HLH and Necrotizing Pneumonia as Unusual Phenotypes and Review of the Literature. J Clin Immunol 2021; 42:299-311. [PMID: 34718934 DOI: 10.1007/s10875-021-01159-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023]
Abstract
Chronic granulomatous disease (CGD) is a rare inborn error of immunity (IEI), characterized by a deficient phagocyte killing due to the inability of NADPH oxidase to produce reactive oxygen species in the phagosome. Patients with CGD suffer from severe and recurrent infections and chronic inflammatory disorders. Onset of CGD has been rarely reported in neonates and only as single case reports or small case series. We report here the cases of three newborns from two different kindreds, presenting with novel infectious and inflammatory phenotypes associated with CGD. A girl with CYBA deficiency presented with necrotizing pneumonia, requiring a prolonged antibiotic treatment and resulting in fibrotic pulmonary changes. From the second kindred, the first of two brothers developed a fatal Burkholderia multivorans sepsis and died at 24 days of life. His younger brother had a diagnosis of CYBB deficiency and presented with Macrophage Activation Syndrome/Hemophagocytic Lympho-Histiocytosis (MAS/HLH) without any infection, that could be controlled with steroids. We further report the findings of a review of the literature and show that the spectrum of microorganisms causing infections in neonates with CGD is similar to that of older patients, but the clinical manifestations are more diverse, especially those related to the inflammatory syndromes. Our findings extend the spectrum of the clinical presentation of CGD to include unusual neonatal phenotypes. The recognition of the very early, potentially life-threatening manifestations of CGD is crucial for a prompt diagnosis, improvement of survival and reduction of the risk of long-term sequelae.
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Affiliation(s)
- Antonio Marzollo
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128, Padua, Italy. .,Fondazione Citta' Della Speranza, Istituto Di Ricerca Pediatrica, Via Ricerca Scientifica, 4, 35127, Padua, Italy.
| | - Francesca Conti
- Pediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy
| | - Linda Rossini
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128, Padua, Italy
| | - Beatrice Rivalta
- Academic Department of Pediatrics (DPUO), Immune and Infectious Diseases Division, Research Unit of Primary Immunodeficiencies, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Lucia Leonardi
- Maternal, Infantile and Urological Sciences Department, Sapienza University of Rome, Rome, Italy
| | - Caterina Tretti
- Maternal and Child Health Department, Padua University, Via Giustiniani 3, 35128, Padua, Italy
| | - Francesca Tosato
- Department of Laboratory Medicine, University Hospital of Padova, Padova, PD, Italy
| | - Maria Chiriaco
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | | | - Cristina Tea Natalucci
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128, Padua, Italy
| | - Maddalena Martella
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Via Giustiniani 3, 35128, Padua, Italy
| | - Alessandro Borghesi
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Cecilia Mancini
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Andrea Ciolfi
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Gigliola di Matteo
- Academic Department of Pediatrics (DPUO), Immune and Infectious Diseases Division, Research Unit of Primary Immunodeficiencies, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Caterina Cancrini
- Academic Department of Pediatrics (DPUO), Immune and Infectious Diseases Division, Research Unit of Primary Immunodeficiencies, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Alessandra Biffi
- Maternal and Child Health Department, Padua University, Via Giustiniani 3, 35128, Padua, Italy
| | - Andrea Finocchi
- Academic Department of Pediatrics (DPUO), Immune and Infectious Diseases Division, Research Unit of Primary Immunodeficiencies, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy.,Department of Systems Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Silvia Bresolin
- Maternal and Child Health Department, Padua University, Via Giustiniani 3, 35128, Padua, Italy
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